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Quantified terminal ileal motility during MR enterography as a potential biomarker of Crohn’s disease activity: a preliminary study

  • Gastrointestinal
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Abstract

Objective

To compare quantified terminal ileal (TI) motility during MR enterography (MRE) with histopathological severity of acute inflammation in Crohn’s disease.

Methods

A total of 28 Crohn’s patients underwent MRE and endoscopic TI biopsy. Axial and coronal TrueFISP, HASTE and post-gadolinium VIBE images were supplemented by multiple coronal TrueFISP cine motility sequences through the small bowel volume. TI motility index (MI) was quantified using validated software; an acute inflammation score (eAIS; 0–6) was assigned to the biopsy. Two observers qualitatively scored mural thickness, T2 signal, contrast enhancement and perimural oedema (0–3) to produce an activity score (aMRIs) based on anatomical MRI. The association among the MI, eAIS and aMRIs was tested using Spearman’s rank correlation. Wilcoxon rank sum test compared motility in subjects with and without histopathological inflammation.

Results

Mean MI and mean eAIS were 0.27 (range 0.06–0.55) and 1.5 (range 0–5), respectively. There was a significant difference in MI between non-inflamed (mean 0.37, range 0.13–0.55) and inflamed (mean 0.19, range 0.06–0.44) TI, P = 0.002, and a significant negative correlation between MI and both eAIS (Rho = −0.52, P = 0.005) and aMRIs (R = −0.7, P < 0.001).

Conclusion

Quantified TI motility negatively correlates with histopathological measures of disease activity and existing anatomical MRI activity biomarkers.

Key Points

• Magnetic resonance imaging is increasingly used to assess Crohn’s disease.

• MRI measurements can provide a quantitative assessment of small bowel motility.

• MR enterography can grade Crohn’s disease.

• Small bowel motility can be used as a marker of inflammatory activity.

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Acknowledgement

This work was undertaken at the Comprehensive Biomedical Centre, University College Hospital London, which received a proportion of the funding from the National Institute for Health Research. The views expressed in this publication are those of the authors and not necessarily those of the UK Department of Health. Grant funding from the pathological Society of Great Britain & Ireland.

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Authors and Affiliations

  1. Centre for Medical Imaging, University College London, London, UK

    Alex Menys, David Atkinson, Asia Ahmed, Shonit Punwani, Steve Halligan & Stuart A. Taylor

  2. INSERM U947, Nancy University, Nancy, France

    Freddy Odille

  3. Histopathology, University College London, London, UK

    Marco Novelli, Manuel Rodriguez-Justo & Ian Proctor

  4. Department of Specialist Radiology, University College London Hospital, Podium Level 2, 235 Euston Road, London, UK, NW1 2BU

    Stuart A. Taylor

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  1. Alex Menys
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  2. David Atkinson
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  3. Freddy Odille
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  4. Asia Ahmed
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  5. Marco Novelli
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  6. Manuel Rodriguez-Justo
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  7. Ian Proctor
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  8. Shonit Punwani
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  9. Steve Halligan
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  10. Stuart A. Taylor
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Correspondence to Stuart A. Taylor.

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Menys, A., Atkinson, D., Odille, F. et al. Quantified terminal ileal motility during MR enterography as a potential biomarker of Crohn’s disease activity: a preliminary study. Eur Radiol 22, 2494–2501 (2012). https://doi.org/10.1007/s00330-012-2514-2

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  • DOI: https://doi.org/10.1007/s00330-012-2514-2

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